NPI | 1730158627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL 74193) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 37010) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 37010) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2024-04-13 |